Buma Chloe, Saunders Colleen, Watermeyer Jennifer, Stassen Willem
Division of Emergency Medicine, University of Cape Town, South Africa.
Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, South Africa.
Afr J Emerg Med. 2020 Dec;10(4):203-208. doi: 10.1016/j.afjem.2020.06.012. Epub 2020 Jul 21.
Acute myocardial infarction (AMI) is a time sensitive emergency. In resource limited settings, prompt identification and management of patients experiencing AMI in the pre-hospital setting may minimise the negative consequences associated with overburdened emergency medical and hospital services. Expedited care thus, in part, relies on the dispatch of appropriate pre-hospital medical providers by emergency medical dispatchers. Identification of these patients in call centres is challenging due to a highly diverse South African society, with multiple languages, cultures, and levels of education. The aim of this study was therefore, to describe the terms used by members of the South African public when calling for an ambulance for patients suffering an AMI.
In this qualitative study, we performed content analysis to identify keywords and phrases that callers used to describe patients who were experiencing an advanced life support (ALS) paramedic-diagnosed AMI. Using the unique case reference number of randomly selected AMI cases, original voice recordings between the caller and emergency medical dispatcher at the time of the emergency were extracted and transcribed verbatim. Descriptors of AMI were identified, coded and categorised using content analysis, and quantified.
Of the 50 randomly selected calls analysed, 5 were not conducted in English. The descriptors used by callers were found to fall into three categories; , and . The code that occurred most often was no pain, (n = 16; 23.2%), followed by the code describing pain in the chest (n = 15; 21.7%).
South African callers use a consistent set of descriptors when requesting an ambulance for a patient experiencing an AMI. The most common of these are non-pain descriptors related to the heart. These descriptors may ultimately be used in developing validated algorithms to assist dispatch decisions. In this way, we hope to expedite the correct level of care to these time- critical patients and prevent the unnecessary dispatch of limitedly available ALS paramedics to inappropriate cases.
急性心肌梗死（AMI）是一种对时间敏感的急症。在资源有限的环境中，在院前环境中对急性心肌梗死患者进行及时识别和管理，可将与负担过重的紧急医疗和医院服务相关的负面后果降至最低。因此，快速护理在一定程度上依赖于紧急医疗调度员派遣合适的院前医疗人员。由于南非社会高度多元化，存在多种语言、文化和教育水平，在呼叫中心识别这些患者具有挑战性。因此，本研究的目的是描述南非公众在为急性心肌梗死患者呼叫救护车时使用的术语。
在这项定性研究中，我们进行了内容分析，以识别呼叫者用于描述经高级生命支持（ALS）护理人员诊断为急性心肌梗死患者的关键词和短语。利用随机选择的急性心肌梗死病例的唯一病例参考编号，提取了紧急情况下呼叫者与紧急医疗调度员之间的原始语音记录，并逐字转录。使用内容分析识别、编码和分类急性心肌梗死的描述符，并进行量化。
在分析的50个随机选择的呼叫中，有5个不是用英语进行的。发现呼叫者使用的描述符分为三类； 、 和 。出现频率最高的代码是无疼痛， （n = 16；23.2%），其次是描述胸痛的代码（n = 15；21.7%）。
南非呼叫者在为急性心肌梗死患者呼叫救护车时使用一套一致的描述符。其中最常见的是与心脏相关的无疼痛描述符。这些描述符最终可用于开发经过验证的算法，以协助调度决策。通过这种方式，我们希望为这些对时间要求严格的患者加快提供正确水平的护理，并防止将有限的ALS护理人员不必要地派往不适当的病例。
